Accessibility disclaimer: To obtain information contained in document files on this page in an accessible format please contact the IU School of Medicine Institutional Animal Care and Use Committee (IACUC) by phone at (317) 278-1826 or email at somiacuc@iupui.edu.

Institutional Animal Care and Use Committee (IACUC) Examples & Forms

When submitting to the IACUC, the e-mail must come from the PI’s e-mail address. The form is designed as a Core protocol application with Supplement-Protocol Associate (PA). The Core and Supplement-Protocol Associate (PA) are required for all applications. For specific animal procedures, you will need to check item(s) in the Procedures Check List then complete the corresponding Animal Procedure section(s) as a separate file (Section D).

Once the Core, Animal Procedure section(s) and PA Supplement are completed, send all files to somiacuc@iupui.edu. The IACUC office will combine the Core and Animal Procedure section(s) into one document. The PA Supplement will remain a separate file. The goal with this organization is that you will not have unneeded sections in your protocol, thus making the protocol both shorter in length and quicker to complete for most.

The following two documents are example forms to assist you:

• Example Protocol
• Example Satellite Housing Section

Forms

• Animal Adoption Checklist
• Core Protocol Sections (required)
• Supplement-Protocol Associates (required) (Accessible 07/03/19)
• Section D01—Breeding, Weaning and Genotyping
• Section D02—Anesthetic, Sedation, Analgesia
• Section D03—Surgical Procedures
• Section D04—Agent Administration
• Section D05—Irradiation/Imaging with Ionizing Radiation and Other Radioisotope Administration
• Section D06—Body Fluid, Tissue and Device Collection and Blood Sampling
• Section D07—Behavior Tests and Adverse Stimuli
• Section D08—Special Caging, Husbandry, Food/Water Deprivation/Restriction
• Section D09—Immunization
• Section D10—Hybridoma
• Section D11—Physical Restraint
• Section D12—Laser
• Section D13—Satellite Housing
• Section D14—Animal Identification/Marking
• Section D15—VA Supplemental Documentation
• Section D16—Controlled Substances
• Appendix 1—Food and Water Restriction or Deprivation
• Appendix 2—Anesthetic/Sedation General Criteria
• Appendix 3—Analgesia
• Appendix 4—Pre-Surgical Preparation Disinfectant Guidelines

IACUC Protocol Related Forms

• Breeding Attachment spreedsheet
  To be used with the breeding section D01
• Training Documentation (Accessible 07/03/19)
  To be used to document training
• IACUC Funding Update Form (Accessible 07/03/19)
  To be used to update funding on a protocol
• Protocol Associate Addition Form (Accessible 07/17/19)
  To add new protocol associates
• Continuing Review Form
• Training Exemption Form (Observe)
  To be used for people visiting IU and who will only observe procedures currently approved on a protocol(s) and will not have any interaction with live animals.
• Training Exemption Form (Learn or Teach)
  To be used for people visiting IU and who will learn/teach a procedure(s) currently approved on a protocol(s) and will have interaction with live animals.
• Custom Made Antibody Form
• Custom Made Antibody Approved Vendor List